Spinal cord stimulation (SCS) has emerged as a potential viable means of managing chronic pain whereas other treatment means such as kinetic (physical rehabilitation), pharmaceutical, and surgical therapies have not been effective. Studies of the clinical success of SCS, however, have been highly variable and recent years have shown very little improvement in its success. Conventional clinical SCS is typically accompanied by side-effects including paresthesias, or tingling sensations associated with neural activation of the dorsal columns, over the region of pain. These paresthesias may adversely affect patient satisfaction with therapy and compliance. Efforts to improve clinical efficacy of SCS and to reduce paresthesias associated with SCS have not focused on the effect of SCS on the activity of neurons in the dorsal horn pain processing circuit. Recently, novel methods of SCS, including pulsed SCS and high frequency SCS have been claimed to provide pain relief comparable to clinical SCS with significantly reduced paresthesias. These approaches, however, may be suboptimal, as they neither search for nor implement parameters that have been algorithmically determined to be optimal for efficacy (reduction of neural activity associated with pain relief), efficiency (power consumption), and paresthesia reduction.
SCS therapy involves the epidural implantation of an electrode that is connected to a controller capable of delivering electrical stimulation to neural elements in the spinal cord responsible for the modulation and transmission of pain to the brain. However, SCS programmers are currently only capable of configuring SCS devices to deliver constant inter-pulse interval (IPI) stimulation. Recent developments in SCS feature technologies that have been claimed to be able to provide pain relief with reduced side effects, but these methods do not use or provide a means to set stimulation parameters that are optimized for efficacy, efficiency, and side effect reduction. No prior technology includes a device that has the capability of remotely programming an SCS delivery device with optimized non-regular temporal patterns or multiple frequency combinations through one or multiple electrode contacts.